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Aterosklerotik Kardiyovasküler Hastalık Risk Skoru Bilgilendirmesinin Obezite Merkezine Başvuran Hastalarda Risk Azalmasına Etkisi

Year 2021, Volume: 15 Issue: 1, 129 - 135, 09.03.2021
https://doi.org/10.21763/tjfmpc.798484

Abstract

Amaç: Aterosklerotik kardiyovasküler hastalık (ASKVH), dünya çapında en yaygın mortalite ve morbidite nedenidir. Bu çalışmanın amacı 40-79 yaşları arasındaki obez hastalarda aterosklerotik kardiyovasküler hastalık risk skoru bilgisinin 3 aylık dönemde risk azalmasına etkisini değerlendirmektir. Yöntem: Bu tanımlayıcı ve kesitsel çalışma klinik etik komitesi tarafından onaylandıktan sonra çalışma Konya Obezite Merkezine başvuran ardışık 300 gönüllü hasta ile yapılmıştır. Çalışmaya katılmaya gönüllü olan 40 yaş üstü tüm hastalar dahil edildi. Koroner arter hastalığı, kalp yetmezliği, majör depresyon, aritmi tedavisi gören, 40 yaş altı ve üçüncü ay kontrollerine gelemeyen hastalar çalışma dışı bırakıldı. Obezite merkezine başvuran hastalar rutin tetkik sonuçlarına göre değerlendirilmektedir. Bulgular: Tek değişkenli analizimizde ASKVH risk skoru bilgilendirmesi, yaş, cinsiyet, meslek, medeni durum, diyabet, hiperlipidemi, SBP, WC, HC, TC, LDL, trigliseridler, glikoz, HbA1c ve AST; ASKVH riskinin önemli belirleyicileriydi. ASKVH risk skoru bilgisi (olasılık oranı [OR]: 1725,917; % 95 CI: 208,675-14275,098; p <0,001), yaş (OR: 0,936; % 95 CI: 0,882-0,994; p=0,030), cinsiyet (OR: 65,848; % 95 Cl: 11,455-378,505; p <0,001), meslek (OR: 0,410; % 95 Cl: 0,259-0,648; p <0,001) ve toplam kolesterol (OR: 0,960; % 95 Cl:0,940-0,980; p <0,001) ASKVH risk azaltımı için çok değişkenli öngörücüler olarak tanımlandı. Sonuç: Sonuç olarak, analizimiz ASKVH risk skoru bilgisi, yaş, cinsiyet, meslek ve başvuru sırasında ölçülen TC bilgisinin ASCVD risk puanlamasındaki azalmanın en güçlü belirleyicileri olduğunu gösterdi. KVH'ler açısından risk azaltımı sağlamak için, hastaların KVH risklerine ilişkin farkındalıkları çok önemli bir rol oynar.

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References

  • 1. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139(10):e56-e528.
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  • 3. Molvin J, Jujic A, Nilsson PM, Leosdottir M, Lindblad U, Daka B, et al. A diabetes‐associated genetic variant is associated with diastolic dysfunction and cardiovascular disease. ESC Heart Failure. 2019;7(1):348-356.
  • 4. Gidding SS. Familial Hypercholesterolemia: now part of cardiovascular disease genetic epidemiology research. Journal of the American College of Cardiology; 2016;67(22):2590-2592.
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  • 7. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2014;63(25 Part B):2935-59.
  • 8. Karmali KN, Goff DC, Ning H, Lloyd-Jones DM. A systematic examination of the 2013 ACC/AHA pooled cohort risk assessment tool for atherosclerotic cardiovascular disease. Journal of the American College of Cardiology. 2014;64(10):959-68.
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  • 10. Slymen DJ, Drew JA, Elder JP, Williams SJ. Determinants of non-compliance and attrition in the elderly. International journal of epidemiology. 1996;25(2):411-9.
  • 11. Minges KE, Strait KM, Owen N, Dunstan DW, Camhi SM, Lichtman J, et al. Gender differences in physical activity following acute myocardial infarction in adults: a prospective, observational study. European journal of preventive cardiology. 2017;24(2):192-203.
  • 12. Marzolini S, Brooks D, Oh PI. Sex differences in completion of a 12-month cardiac rehabilitation programme: an analysis of 5922 women and men. European Journal of Cardiovascular Prevention & Rehabilitation. 2008;15(6):698-703.
  • 13. Kim K-i, Kim M-A, Kim MK, Kim S-H, Kim HS, Moon MK, et al. 2015 Korean guidelines for the management of dyslipidemia: executive summary (English translation). Korean circulation journal. 2016;46(3):275.
  • 14. Kim H, Kim S, Han S, Rane PP, Fox KM, Qian Y, et al. Prevalence and incidence of atherosclerotic cardiovascular disease and its risk factors in Korea: a nationwide population-based study. BMC public health. 2019;19(1):1112.
  • 15. National Clinical Guideline Centre (UK). Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. 2014.
  • 16. Nadeem MK, Mari A, Iftikhar S, Khatri A, Sarwar T, Patel MJ. Hypertension-related Knowledge and Its Relationship with Blood Pressure Control in Hypertensive Patients Visiting a Semi-private Tertiary-care Charity Hospital in Karachi, Pakistan. Cureus. 2019;11(10).
  • 17. Shamsi A, Nayeri ND, Esmaeili M. Living with hypertension: A qualitative research. International journal of community based nursing and midwifery. 2017;5(3):219.
  • 18.Pelin, M. (2017). Kronik hastalık yönetiminde hasta rolü, yaşam kalitesi ve tedaviye uyumun değerlendirilmesi. Sakarya Ünivetrsitesi, Master's thesis, 2017.
  • 19. Anadol, Z., Dişçigil, G. Hipertansif Hastalarda tedavi uyumunu etkileyen faktörler. Türkiye Klinikleri Cardiovascular Sciences, 2009;21(2): 184-190.

The Effect of Atherosclerotic Cardiovascular Disease Risk Score Knowledge on Risk Reduction in Patients Admitted to the Obesity Center

Year 2021, Volume: 15 Issue: 1, 129 - 135, 09.03.2021
https://doi.org/10.21763/tjfmpc.798484

Abstract

Objectives: Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of mortality and morbidity worldwide. The aim of this study was to evaluate the effect of atherosclerotic cardiovascular disease risk score knowledge in obese patients aged 40-79 years on risk reduction in 3 months. Methods: This descriptive and cross-sectional study was approved by the clinical ethics committee. The study was conducted with 300 consecutive volunteer patients who applied to Konya Obesity Center. All patients older than 40 years of age and volunteered to participate in the study were included in the study. Patients with coronary artery disease, heart failure, major depression, treated for arrhythmias, younger than 40 years of age, and those who could not come to the follow-up 3rd-month controls were excluded. The patients admitted to the obesity center were evaluated according to the results of routine examinations. Results: Knowledge of ASCVD risk score, age, gender, occupation, marital status, diabetes, hyperlipidemia, SBP, WC, HC, TC, LDL, triglycerides, glucose, HbA1c and AST were all significantly determinants of ASCVD risk in our univariate analysis. Knowledge of ASCVD (odds ratio [OR]: 1725.917; 95% confidence interval [CI]:208.675-14275.098; p<0.001), age (OR: 0.936; 95% CI:0.882-0.994; p=0.030), gender (OR: 65.848; 95% CI: 11.455-378.505; p<0.001), occupation (OR: 0.410; 95% CI: 0.259-0.648; p<0.001) and total cholesterol (OR: 0.960; 95% Cl: 0.940-0.980; p<0.001) were defined as multivariate predictors for ASCVD risk reduction. Conclusion: In conclusion, our analysis showed that knowledge of ASCVD risk score, age, gender, occupation, and TC at admission were the most potent predictors of decrease in ASCVD risk scoring. In order to achieve risk reduction regarding CVDs, patients’ awareness about knowing their CVD risk plays a crucial role.

References

  • 1. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139(10):e56-e528.
  • 2. Şencan İ, Keskinkılıç B, Ekinci B, Öztemel A, Sarıoğlu G, Çobanoğlu N, et al. Türkiye Kalp ve Damar Hastalıkları Önleme ve Kontrol Programı [Available from: https://www.tkd.org.tr/TKDData/Uploads/files/Turkiye-kalp-ve-damar-hastaliklari-onleme-ve-kontrol-programi.pdf.
  • 3. Molvin J, Jujic A, Nilsson PM, Leosdottir M, Lindblad U, Daka B, et al. A diabetes‐associated genetic variant is associated with diastolic dysfunction and cardiovascular disease. ESC Heart Failure. 2019;7(1):348-356.
  • 4. Gidding SS. Familial Hypercholesterolemia: now part of cardiovascular disease genetic epidemiology research. Journal of the American College of Cardiology; 2016;67(22):2590-2592.
  • 5. Zhang Y, Chen Y, Ma L. Depression and cardiovascular disease in elderly: Current understanding. Journal of Clinical Neuroscience. 2018;47:1-5.
  • 6. Lear SA, Hu W, Rangarajan S, Gasevic D, Leong D, Iqbal R, et al. The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. The Lancet. 2017;390(10113):2643-54.
  • 7. Goff DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2014;63(25 Part B):2935-59.
  • 8. Karmali KN, Goff DC, Ning H, Lloyd-Jones DM. A systematic examination of the 2013 ACC/AHA pooled cohort risk assessment tool for atherosclerotic cardiovascular disease. Journal of the American College of Cardiology. 2014;64(10):959-68.
  • 9. Morris CK, Ueshima K, Kawaguchi T, Hideg A, Froelicher VF. The prognostic value of exercise capacity: a review of the literature. American heart journal. 1991;122(5):1423-31.
  • 10. Slymen DJ, Drew JA, Elder JP, Williams SJ. Determinants of non-compliance and attrition in the elderly. International journal of epidemiology. 1996;25(2):411-9.
  • 11. Minges KE, Strait KM, Owen N, Dunstan DW, Camhi SM, Lichtman J, et al. Gender differences in physical activity following acute myocardial infarction in adults: a prospective, observational study. European journal of preventive cardiology. 2017;24(2):192-203.
  • 12. Marzolini S, Brooks D, Oh PI. Sex differences in completion of a 12-month cardiac rehabilitation programme: an analysis of 5922 women and men. European Journal of Cardiovascular Prevention & Rehabilitation. 2008;15(6):698-703.
  • 13. Kim K-i, Kim M-A, Kim MK, Kim S-H, Kim HS, Moon MK, et al. 2015 Korean guidelines for the management of dyslipidemia: executive summary (English translation). Korean circulation journal. 2016;46(3):275.
  • 14. Kim H, Kim S, Han S, Rane PP, Fox KM, Qian Y, et al. Prevalence and incidence of atherosclerotic cardiovascular disease and its risk factors in Korea: a nationwide population-based study. BMC public health. 2019;19(1):1112.
  • 15. National Clinical Guideline Centre (UK). Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. 2014.
  • 16. Nadeem MK, Mari A, Iftikhar S, Khatri A, Sarwar T, Patel MJ. Hypertension-related Knowledge and Its Relationship with Blood Pressure Control in Hypertensive Patients Visiting a Semi-private Tertiary-care Charity Hospital in Karachi, Pakistan. Cureus. 2019;11(10).
  • 17. Shamsi A, Nayeri ND, Esmaeili M. Living with hypertension: A qualitative research. International journal of community based nursing and midwifery. 2017;5(3):219.
  • 18.Pelin, M. (2017). Kronik hastalık yönetiminde hasta rolü, yaşam kalitesi ve tedaviye uyumun değerlendirilmesi. Sakarya Ünivetrsitesi, Master's thesis, 2017.
  • 19. Anadol, Z., Dişçigil, G. Hipertansif Hastalarda tedavi uyumunu etkileyen faktörler. Türkiye Klinikleri Cardiovascular Sciences, 2009;21(2): 184-190.
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Orijinal Articles
Authors

Duygu İlke Yıldırım 0000-0002-3893-5173

Mehmet Eryılmaz 0000-0002-5280-3943

Publication Date March 9, 2021
Submission Date September 22, 2020
Published in Issue Year 2021 Volume: 15 Issue: 1

Cite

Vancouver Yıldırım Dİ, Eryılmaz M. The Effect of Atherosclerotic Cardiovascular Disease Risk Score Knowledge on Risk Reduction in Patients Admitted to the Obesity Center. TJFMPC. 2021;15(1):129-35.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.